COVID-19: Choosing Wisely

 A time of crisis is not just a time of anxiety and worry. It gives a chance, an opportunity, to choose well or to choose badly. — Desmond Tutu 

Choices have been on my mind lately. Yours too no doubt, as many of the choices we once took for granted in our daily lives — where to shop, when to travel, who to get together with — have been extinguished in the face of a global pandemic.

The choices we make as a civil society, from the federal level through to our individual behaviours, will define the impact of this crisis over time. I’m not going to look into my crystal ball, but I do want to highlight some of the choices we’ve made — and the work all of you have made possible — in recent weeks.

Clinical learners across our Faculty and other health sciences divisions were among the first to feel the impact of frontline pandemic planning. Since early March, the education leads for our clinical programs have taken great care to come together quickly — and often — in the face of changing information, in order to make proactive decisions and communicate quickly to groups of learners and faculty.

It wasn’t long before health and safety considerations for clinical learners had extended to all learners. Among the decisions the Faculty has made, in close collaboration with our University and hospital partners:

• Cancelling international placements and putting in place a two-week self-quarantine for incoming international trainees weeks before this was a national recommendation. 
• Removing all pre-licensure clinical learners from their educational experiences in all clinical settings, from hospitals to clinics and professional offices.
• Creating key procedure documents to address complex issues for those remaining in our clinical training environments.
• Shifting from in-person to digital learning, along with all other University programs. As of this week, rehabs students as well as Year 1 and 2 MD student are learning online. This quick turnaround could not have happened without our dedicated Discovery Commons and program staff working hand in glove.
• Ramping down all non-essential research by end of last week, a not insignificant task for a research-intensive Faculty. Again, our staff have proved exemplary: from Research to Facilities and Space Planning, their leadership and service have helped this process run smoothly.

Like the rest of the city, the University may appear outwardly quiet but we are in no way idle. On the contrary, the outpouring of activity and support from all corners of our community has been phenomenal.

Staff are working full tilt as new needs emerge. Alumni and donors want to know how to help. Learners and faculty are volunteering their time and efforts across the system, demonstrating just how well-suited they are for a life of public service, scientific inquiry and patient care. This dedication and commitment is at the core of who we are as a Faculty and as a community.

As of March 24, the Faculty is focused on:

• Ensuring our pre-licensure clinical trainees can progress in their education, graduate in a timely manner and not face undue hardship alongside their national peers. Our educational leaders will continue their work as unwavering advocates for our learners.
• Safeguarding licensed medical residents and fellows while ensuring they can be redeployed across our system most effectively on the frontlines of COVID-19 patient care. Locally, this requires a deft touch for hospitals to meet their needs in real time. Nationally, this means working to defer national postgraduate exams (now moved to fall) and ensuring licensure considerations post-pandemic fairly protect all learners.
• Supporting the wellness and safety of our clinical teaching faculty as they support the burgeoning patient needs associated with the pandemic.
• Supporting the ~350 Faculty of Medicine faculty, staff, research associates and trainees who are currently coming in to work on campus or at MaRS. While many of us are working from home, these outstanding individuals are providing the essential services needed to keep the Faculty functioning; please note the Provost’s latest message on the Provincial Announcement on Essential Services - Impact on University Operations.
• Connecting with our 250+ international graduate students — many of whom cannot get home due to travel restrictions or financial considerations — to ensure they have the supports they need. Our Graduate and Life Sciences Education office is actively reaching out to all of these students. And work continues with the School of Graduate Studies to effectively support all students in need.
• Rallying our faculty and research networks to meet the national call for Personal Protective Equipment and critical laboratory reagents essential for ongoing COVID-19 clinical testing. Prof. Rita Kandel, Chair of Laboratory Medicine and Pathobiology, is leading this initiative with impressive skill and laser focus. 

We have to be mindful, however, that this crisis will take a toll. It is already taking a toll on some, and we must be careful to safeguard our mental and physical health to meet demands we can’t yet foresee. It will be a long haul ahead, so please take care of yourselves and take care of each other.

Make time for fresh air and sunlight. Embrace digital connections with friends and family. Check in frequently with those you know who live alone.

The Prime Minister reminded us in his address yesterday: the decisions we all make have serious consequences. I urge you to join me and continue to make wise choices ahead for the health and safety of us all.

Salvatore Spadafora
Acting Dean, Faculty of Medicine
University of Toronto